Is CBD Oil Good for AFib? - April 2024

How CBD Oil May Work to Help With AFib

CBD is a nonintoxicating cannabis plant compound that may be associated with reduced inflammation, lower heart rate, increased vasodilation, and reduced blood pressure⁽⁴⁾.

Vasodilation is the ability of blood vessels to widen, which results from the relaxation of blood vessel (vascular) wall muscles⁽⁵⁾. This mechanism enhances blood flow to areas in the body that lack oxygen or nutrients.

Inflammation is associated with atherosclerosis, a condition often connected with most heart attacks due to narrowing arteries⁽⁶⁾.

Heart attacks are among the causes and risk factors of atrial fibrillation (AFib)⁽⁷⁾. Thus, lowering the risk for heart attacks by managing inflammation may help reduce the risk for AFib.

Additionally, heart attacks can also cause heart tissue damage that leads to cardiomyopathy, a heart muscle disease that causes difficulty for the heart to pump blood to the body⁽⁸⁾. Eventually, this condition can lead to heart failure.

One of the ways CBD works in the body is by interacting with the endocannabinoid system (ECS)⁽⁹⁾. The ECS is a regulatory system controlling many critical body functions, such as pain control and immune and inflammatory responses⁽¹⁰⁾.

The ECS contains the CB1 and CB2 cannabinoid receptors. The CB1 receptors in the spinal cord and brain help regulate pain, appetite, and emotional processing⁽¹¹⁾. On the other hand, CB2 receptors in the peripheral nervous system help manage inflammation.

CBD may also have anti-inflammatory and pain-relieving properties and help manage other health issues, such as anxiety, chronic pain, and insomnia⁽¹²⁾.

Researchers conducted a study on rats to determine CBD’s cardioprotective potential⁽¹³⁾. Results suggested that CBD may help reduce ventricular arrhythmias and infarct size.

Arrhythmias are irregular heartbeats, causing an individual’s heart to beat faster or slower. Meanwhile, an infarct is a localized area of dead tissue caused by blood supply failure.

AFib is a form of arrhythmia that can increase the risk for adverse heart-related conditions⁽¹⁴⁾. Therefore, reducing arrhythmia may help alleviate AFib and lower the risk for potential heart problems.

High blood pressure (hypertension) is another risk element for AFib⁽¹⁵⁾. Thus, lowering blood pressure may help decrease AFib risk.

One randomized crossover study conducted on healthy human volunteers showed that a single 600 milligram (mg) dose of CBD may help lower blood pressure⁽¹⁶⁾.

Results also showed that CBD may increase heart rate (often described as making the heart race) and decrease stroke volume.

Stroke volume is the measurement of the amount of blood pumped from the heart during each cardiac contraction.

Despite these potential benefits, the Food and Drug Administration (FDA) has not approved cannabis or cannabis-derived products, such as CBD, as a treatment for any disease or condition⁽¹⁷⁾.

Thus, individuals should consult a doctor, such as a cardiologist, for medical advice regarding atrial fibrillation before considering taking CBD oil products.

Usage and Dosage

Individuals have several administration methods to choose from depending on how they prefer to take CBD to help manage AFib. These methods include:

• Ingestion: This administration route involves taking CBD orally. The compound goes through the body’s digestive tract before spreading into the bloodstream.

Orally administered CBD oil products have a prolonged effect duration, making them preferable for providing an all-night effect⁽¹⁸⁾.

Oral ingestion is considered one of the safest ways to administer CBD⁽¹⁹⁾. Some oral CBD products include capsules, gummies, cookies, and chews.

Some individuals may find oral administration a convenient method to take drugs and may consider purchasing oral CBD products. However, there is no clinical evidence proving that such products are the best choice for AFib.

• Sublingual administration: In this delivery method, an individual administers CBD oil sublingually or under the tongue, allowing the drug to bypass the digestive tract and enter the bloodstream directly.

Common sublingual products include CBD oil tinctures and oromucosal sprays. Tinctures come with calibrated droppers to allow individuals to adjust the CBD amount for more accurate dosing.

Tinctures are usually formulated with carrier oils, such as medium-chain triglyceride (MCT) oil or coconut oil, to help dilute the CBD concentrate.

CBD tinctures typically have an earthy flavor. Some individuals may prefer mixing these products with food or drinks⁽²⁰⁾.

Other products administered sublingually include tablets, high-potency oils, and oromucosal sprays.

• Topical application: This method involves applying CBD to the skin. CBD topicals provide pain relief to a specific area and are not absorbed into the bloodstream⁽²¹⁾.

Examples of CBD topical products include CBD creams, ointments, salves, and lotions.

• Inhalation: This method is a quick way to administer cannabis products through vaping or smoking and may be suitable for problems like acute pain or nausea⁽²²⁾.

CBD delivery through inhalation involves vaping or smoking the product. Inhalation allows CBD to enter the lungs then the heart and be absorbed into the brain before spreading throughout the body⁽²³⁾.

Individuals should take caution before purchasing vapes as these products can cause health risks leading to lung disease⁽²⁴⁾.

Before using CBD to help manage existing medical conditions, individuals must consult a doctor or healthcare professional for a diagnosis and appropriate treatment.

Regarding dosage, the FDA has not endorsed any standard dosing guide for CBD specific to atrial fibrillation.

An individual’s CBD dosage requirements may vary from other users due to factors like diet, health conditions, stress levels, genetics, and exercise⁽²⁵⁾.

However, individuals new to using CBD may consider starting with a low dose and slowly increasing the dosage⁽²⁶⁾.

For example, individuals using CBD-rich products may take an initial dose of 10mg of CBD per day⁽²⁷⁾. If these products contain tetrahydrocannabinol (THC), users may start with a low THC dose of 1 to 2.5mg.

THC is a substance derived from the cannabis plant and is typically associated with marijuana usage because of the substance’s psychoactive effects that produce a feeling of “high”⁽²⁸⁾.

One study mentioned that humans may tolerate high CBD doses of 1,500mg per day⁽²⁹⁾.

Pros and Cons of CBD Oil for AFib

THC induces psychoactive effects. However, compared to THC, CBD is not psychoactive and, therefore, will not make a user high like THC does⁽³⁰⁾.

Another advantage of CBD is that the World Health Organization (WHO) considers the substance to have a good safety profile and well tolerated in humans⁽³¹⁾. CBD also does not appear to produce effects of drug abuse.

However, scientists have not established any conclusive cardiovascular benefits of CBD for AFib, and there may be a possibility for adverse effects to occur, especially when an individual with heart problems takes the compound.

Thus, individuals with health problems should consult a doctor to diagnose and treat health problems instead of taking CBD first.

Effectiveness

Researchers have not conducted clinical studies suggesting CBD oil directly helps alleviate AFib. Thus, there is no conclusive evidence that CBD effectively manages irregular heartbeats associated with this particular health condition.

Regarding onset times, no conclusive clinical trials determine how long CBD starts to take effect for AFib specifically.

In general, oral CBD products may take approximately 30 to 90 minutes for the compound to take effect⁽³²⁾. Meanwhile, CBD’s onset time is between 15 and 30 minutes for sublingual and topical products, while CBD administered through vaping is around 2 to 15 minutes.

Additionally, the time it takes for CBD’s effects to last may vary depending on the delivery route, such as the following⁽³³⁾:

• Sublingual administration: Two to four hours
• Oral ingestion: Six to eight hours
• Topical application: Two to four hours
• Inhalation: Two to four hours

In one study published in Frontiers of Pharmacology, researchers mentioned that orally administered CBD may have a half-life of two to five days⁽³⁴⁾.

The same study also stated that administering CBD oromucosal sprays at 5mg and 20mg doses may give the substance a half-life of 1.4 and 10.9 hours, respectively.

Half-life is the duration for a medication’s concentration or quantity in the body to decrease by 50%.

Side Effects

Researchers have not conducted thorough studies on the side effects of CBD when used specifically for AFib.

However, one study mentioned that tiredness, diarrhea, and changes in appetite or body weight are among CBD’s commonly reported side effects⁽³⁵⁾.

In another study conducted on patients who were prescribed CBD oil, researchers mentioned that some participants experienced vivid dreams and sedation⁽³⁶⁾.

Although CBD may cause side effects, they are generally tolerable among humans⁽³⁷⁾.

How to Choose the Right CBD for AFib

When choosing the best CBD oil for atrial fibrillation, individuals should look into the extraction methods, lab test results, CBD product types, and personal preferences.

Extraction Methods

Manufacturers derive CBD and other compounds from the cannabis plant through various extraction processes depending on the manufacturer’s preferences. These methods include carbon dioxide (CO2), ethanol, or hydrocarbon extraction.

• CO2 extraction: In this technique, manufacturers utilize highly pressurized carbon dioxide to extract CBD.

Carbon dioxide is a colorless, odorless, noncombustible gas that the FDA affirms as generally recognized as safe (GRAS) for food use⁽³⁸⁾.

• Ethanol extraction: Ethanol, or ethyl alcohol, is used as a solvent for extracting CBD from the cannabis plant.

Manufacturers consider ethanol safer to work with than butane and may be more efficient than CO2⁽³⁹⁾.

However, ethanol is an “exhaustive” solvent, meaning it may need additional refinement to remove unwanted plant compounds, such as chlorophyll. This extra process can lower the final product’s potency⁽⁴⁰⁾.

For centuries, many cultures have used this method to derive medicinal compounds from cannabis⁽⁴¹⁾.

• Hydrocarbon extraction: In this method, CBD manufacturers use hydrocarbons like propane or butane to derive CBD from hemp.

A significant safety issue with hydrocarbons is that they are neurotoxic and flammable compounds. Hydrocarbons can cause a health risk if not wholly purged from the CBD extract.

However, manufacturers consider hydrocarbon extraction an effective method for extracting CBD, provided that individuals performing the extraction follow the proper safety and handling procedures⁽⁴²⁾.

Product Categorization

After extracting the hemp extract and processing it into CBD oil, manufacturers categorize the extract as full-spectrum, broad-spectrum, or isolate.

• Full-spectrum CBD oil: This product typically contains all beneficial cannabis plant compounds and cannabinoids. These compounds may include THC, flavonoids, and terpenes.

Terpenes produce a distinct aroma in cannabis plants and are considered essential oil constituents that may also have therapeutic benefits, particularly aromatherapy⁽⁴³⁾.

Meanwhile, flavonoids are plant substances that may function as antioxidants and antimicrobials⁽⁴⁴⁾.

The presence of these compounds may create an “entourage effect” in full-spectrum CBD oil. This effect is characterized by the synergistic activity of these cannabis compounds that work together to give better therapeutic results⁽⁴⁵⁾.

• Broad-spectrum CBD oil: This product does not contain THC. However, broad-spectrum CBD oil contains most cannabinoids typically found in full-spectrum CBD oil products.
• CBD isolates: CBD isolates are made from pure CBD only. These products have no THC and do not contain any other compounds or cannabinoids.

Individuals who prefer THC-free CBD products or are averse to THC’s psychoactive effects may consider purchasing CBD isolates or broad-spectrum CBD oil products.

However, consumers interested in the entourage effect or the full benefits of CBD may opt for full-spectrum CBD oil.

Third-Party Lab Tests

Third-party labs provide certificates of analysis (COAs) for CBD items. COAs are detailed reports of a CBD product’s actual content.

Third-party analysis and testing are industry-standard procedures necessary to reduce concerns regarding falsely labeled products⁽⁴⁶⁾.

Reputable and transparent CBD brands typically send their product samples to third-party labs for testing. Once the COAs are available, the brands upload these COAs on the product website and ensure these reports are publicly available.

Some third-party labs also test products for harmful contaminants, such as heavy metals, pesticides, or solvents, hazardous to consumers’ health.

When looking for high-quality CBD products, individuals should consider buying from a CBD brand that provides updated and detailed COAs on its website. Individuals may also compare the COA results with the CBD product’s label to ensure consistency.

Individual Preferences

Consumers have varied preferences, which can also be a factor when deciding what CBD product to purchase.

For instance, some individuals may prefer non-GMO or gluten-free CBD products made from organic hemp from hemp farms in the United States.

Other consumers may choose a product depending on their personal goals or needs, such as wellness or lifestyle changes.

Still, some individuals may choose brands that provide discounts, subscriptions, favorable customer reviews, or money-back guarantees.

How CBD Oil Compares to Alternative Treatments for AFib

There are no conclusive studies comparing the effectiveness of CBD’s purported therapeutic benefits with other alternative remedies for AFib.

Additional research is needed to establish an objective comparison between CBD and alternative therapies in managing AFib or AFib symptoms.

Aside from using CBD oil, individuals may also consider other alternative remedies to help manage AFib. These options include the following:

• Yoga: This therapy is considered part of ancient Indian science comprising three elements: meditation (dhyana), body postures (asanas), and breathing exercises (pranayama).

In one study, 52 individuals aged between 18 and 80 years with paroxysmal AFib enrolled in a yoga session⁽⁴⁷⁾.

Results showed that performing yoga for 60 minutes a day three times a week for three months may help decrease symptomatic AFib and non-AFib episodes.

• Acupuncture: This treatment method is a part of traditional Chinese medicine based on the belief that humans have life energy called Qi that flows throughout the body.

A study on acupuncture effectiveness showed that the procedure achieved conversion (cardioversion) in 85% of individuals with AFib and atrial flutter (a form of arrhythmia)⁽⁴⁸⁾.

In comparison, only 67.5% in the control group treated with amiodarone, an antiarrhythmic medication, achieved conversion.

Cardioversion is the conversion of the heartbeat from an abnormal state to a normal rhythm.

• Vitamins and antioxidants: Vitamins C and E are antioxidants purported to help manage AFib by suppressing oxidative stress and reducing arrhythmogenesis (triggering arrhythmia incidence)⁽⁴⁹⁾.

One study showed that oral vitamin C supplementation may help lower AFib recurrence after cardioversion⁽⁵⁰⁾.

Further studies suggested that vitamins C and E may decrease the risk of developing AFib after an individual undergoes cardiac surgery⁽⁵¹⁾.

• Omega-3 fatty acids: Omega-3 is a type of polyunsaturated fatty acid that may benefit various cardiovascular conditions.

Clinical studies showed that omega-3 (also called n-3) polyunsaturated fatty acids may help lower AFib recurrence after cardioversion⁽⁵²⁾.

However, another study mentioned no difference between n-3 polyunsaturated fatty acids and placebo during a one-year trial to determine the effectiveness of omega-3 in reducing recurrent AFib⁽⁵³⁾.

The mixed results of these studies suggest further research to conclusively determine if omega-3 fatty acids are effective against AFib.

• Herbal medicine: Researchers have also studied the effectiveness of various herbs in helping manage AFib.

Plants such as barberry, cinchona, motherwort, and wenxin keli may have cardiovascular benefits that may help manage AFib or its symptoms⁽⁵⁴⁾.

Other alternative forms of therapy that some individuals claim may work on AFib include homeopathy and Ayurveda⁽⁵⁵⁾.

Homeopathy involves curing a disease using substances that may produce similar symptoms in healthy individuals⁽⁵⁶⁾.

Meanwhile, Ayurveda is a traditional Indian medical system based on the belief that illness comes from an imbalance of one’s prana or life force. Ayurveda utilizes herbs, massage, diet, yoga, meditation, and internal cleansing to restore the body’s balance⁽⁵⁷⁾.

However, researchers have not conducted extensive clinical studies on the effectiveness of homeopathy or Ayurveda on AFib.

Legality

The legality of using CBD oil or medical marijuana varies from one state to another. Before purchasing CBD products, consumers must know and understand their state’s laws regarding CBD use.

According to United States federal law, CBD products whose THC content exceeds 0.3% are illegal⁽⁵⁸⁾.

The 2018 Farm Bill mandates the United States Department of Agriculture (USDA) to establish a regulatory framework for hemp production⁽⁵⁹⁾. The law also removed hemp and other cannabis derivatives containing no more than 0.3% THC from the Controlled Substances Act’s definition of “marijuana”⁽⁶⁰⁾.

The United States has regulated cannabis programs that vary across states. As of February 2022, about 37 states allow cannabis for medical use, including New York, Illinois, Washington, Colorado, and California⁽⁶¹⁾.

In 2020, the FDA only approved Epidiolex, an oral medication containing CBD in purified form, for treating seizures associated with epilepsy⁽⁶²⁾.

Furthermore, the FDA warns that labeling or marketing CBD products as food additives or dietary supplements is illegal⁽⁶³⁾. Due to the FDA’s limited data on CBD’s safety, the agency advises that individuals consider the potential risks before using CBD.

What Is Atrial Fibrillation?

Atrial fibrillation (AFib) is a quick and irregular heart rhythm (arrhythmia) that can cause blood clots in the heart⁽⁶⁴⁾. AFib can escalate the risk of heart failure, stroke, and other heart-related disorders.

When an individual has AFib, the atria (upper heart chambers) beat irregularly and out of sync with the ventricles (lower heart chambers). Many different electrical impulses fire simultaneously, causing a fast and chaotic rhythm to the atria, rendering this chamber ineffective in pumping blood to the ventricles⁽⁶⁵⁾.

More than 33 million individuals over 55 years old have been diagnosed with the disease worldwide, with an estimated 12 million citizens in the United States having AFib by 2030⁽⁶⁶⁾.

Researchers have suggested that AFib is the “new cardiovascular disease epidemic” in the 21st century⁽⁶⁷⁾.

Symptoms of Atrial Fibrillation

Some individuals with AFib may not show symptoms. Still, individuals with this condition may experience the following⁽⁶⁸⁾:

• Palpitations or fast, pound heartbeat
• Chest pain
• Shortness of breath
• Fatigue
• Dizziness
• Weakness

If left untreated, AFib can cause complications such as the increased risk for stroke or lower cardiac output due to loss of atrial contraction⁽⁶⁹⁾.

Causes and Risk Factors of Atrial Fibrillation

Health conditions that cause heart structure problems can often lead to AFib. These conditions include the following⁽⁷⁰⁾:

• Heart attack
• High blood pressure
• Congenital heart defect
• Coronary heart disease
• Sleep apnea
• Physical stress caused by surgery or illnesses
• Past heart surgery
• Viral infections
• Use of stimulants

Additionally, some individuals with no known adverse heart conditions may still develop AFib.

Other factors that increase an individual’s risk of AFib are the following⁽⁷¹⁾:

• Age: Older individuals are likely at risk of developing AFib.
• Heart diseases: Individuals with preexisting heart diseases, such as congenital heart disease, coronary heart disease, or heart attack history, have a higher risk of getting AFib.
• Family history: Families with a history of AFib are likely to develop the disease among their members.
• High blood pressure: Among individuals with high blood pressure, those who do not control this condition with medications or lifestyle changes have a high AFib risk.
• Chronic health conditions: Individuals with chronic conditions, such as diabetes, lung disease, sleep apnea, or chronic kidney disease, are likely to experience AFib.
• Obesity: Individuals with excessive amounts of fat in their bodies are at a higher risk of developing AFib.
• Alcohol consumption: Some alcoholics, especially those fond of binge drinking, may have an increased risk of AFib, and drinking alcohol can trigger episodes of such disease.

The Different Types of Atrial Fibrillation

Atrial fibrillation has the following types:

• Occasional: This type is also called paroxysmal atrial fibrillation. Occasional AFib has symptoms typically lasting for a few minutes to several hours.

Symptoms can occur for as long as one week, and episodes can happen frequently. Symptoms may disappear on their own. However, some people with occasional AFib will need treatment.

• Persistent: In this AFib type, the heart rhythm does not return to normal. A person with persistent AFib symptoms may take medications or undergo cardioversion to restore and maintain a normal heart rhythm.
• Long-standing persistent: This AFib type occurs continuously and may last longer than 12 months.
• Permanent: A permanent AFib is an irregular heart rhythm that cannot be restored. Individuals must take medications for heart rate control and prevent blood clots.

Treatment

There are several options for treating AFib depending on the underlying cause of the condition, the symptoms, and how long the individual had the disease. These options can involve medication, cardioversion therapy, or surgery.

A doctor or cardiology expert can prescribe the following medications for AFib⁽⁷²⁾:

• Beta-blockers: Help slow down heart rate at rest or during an activity.
• Blood thinners (anticoagulants): Reduce the risk of organ damage or stroke due to blood clots. Blood thinners include warfarin (Jantoven), dabigatran (Pradaxa), and edoxaban (Savaysa).
• Calcium channel blockers: Helps control an individual’s heart rate. Individuals with low blood pressure or heart failure must avoid these medications.
• Digoxin: Help control heart rate at rest. However, digoxin may not work effectively during activity, and individuals may opt for calcium channel blockers or beta-blockers instead.

For individuals experiencing bothersome AFib symptoms, doctors can attempt a cardioversion procedure to reset the heart’s rhythm. There are two ways to perform this therapy:

• Electrical cardioversion: This procedure uses electrode patches placed on the chest to send electric shocks to the heart to reset the heart rhythm.
• Drug cardioversion: This method administers intravenous (IV) medications that help reset the heart rhythm.

Finally, if medications or therapies do not reduce AFib, the doctor can recommend cardiac ablation.

In this procedure, the doctor attempts to create scars in the heart that serves as a blockage to disrupt abnormal electric signals and restore normal heartbeat through surgery or catheter tube insertion.

Cardiac ablation procedures include the following:

• Maze procedure: The doctor applies cold or heat energy or uses a scalpel to create a scar tissue pattern called the “maze” in the upper heart chambers.
• Atrioventricular (AV) node ablation: The physician applies cold or heat energy to the heart tissue’s AV node to disrupt the electric signal connection.

Ablation procedures may work best for young patients who do not have significant structural heart disease, patients with drug-resistant AFib, or patients with heart failure and left ventricular systolic dysfunction.

A heart-healthy lifestyle may help individuals manage cardiovascular system problems such as heart disease and high blood pressure. Individuals seeking alternative ways to help manage AFib may consider the following lifestyle changes⁽⁷³⁾:

• Exercise regularly: This activity, when performed daily, may help increase physical activity.
• Eat heart-healthy foods: This diet comprises foods low in salt and solid fats and containing vegetables, fruits, and whole grains.
• Maintain a healthy weight: Being overweight increases the chance of developing heart disease. Healthy weight loss can help manage AFib symptoms.
• Keep cholesterol levels and blood pressure under control: Individuals must make lifestyle changes and take prescribed medications to help manage high cholesterol or high blood pressure.
• Quit smoking: Individuals who find quitting difficult should talk to their doctor about programs or strategies that can help break a smoking habit.
• Limit alcohol intake: Binge drinking or excessive alcohol use can increase an individual’s chances of getting AFib. Some people have low or moderate alcohol tolerances, which can easily trigger AFib.
• Get follow-up care: Individuals must take their prescribed medications and have regular follow-up appointments with their physician. Individuals should also inform their doctor if health conditions worsen.

What Is Cardiac Rehabilitation?

Cardiac rehabilitation or cardiac rehab is a medically supervised program to help individuals recover from heart attacks or other heart problems⁽⁷⁴⁾. This program typically includes exercise, counseling, support, and education.

Cardiac rehab may help individuals who have experienced any of the following heart conditions⁽⁷⁵⁾:

• Heart failure
• Heart attack
• Angina (chest pain due to decreased blood flow to the heart)
• Coronary artery bypass graft
• Heart or heart-lung transplant

This program has three phases, starting from before the hospital discharges the patient and continuing long-term:

• Phase 1: Inpatient
• Phase 2: Outpatient
• Phase 3: Individuals maintain the program themselves

Healthcare providers such as doctors, dietitians, nurses, and counselors can offer expert advice and guidance to the individual throughout the cardiac rehab program.

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2. Acute Administration of Cannabidiol In Vivo Suppresses Ischaemia-Induced Cardiac Arrhythmias and Reduces Infarct Size When Given at Reperfusion
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936031/
3. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD)
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4. Cannabis Use Shows Substantial Risks, No Benefits for Cardiovascular Health; More Research Is Critical
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5. Physiology, Vasodilation
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6. Cannabis Use Shows Substantial Risks, No Benefits for Cardiovascular Health; More Research Is Critical
   https://newsroom.heart.org/news/cannabis-use-shows-substantial-risks-no-benefits-for-cardiovascular-health-more-research-is-critical
7. Atrial Fibrillation: Symptoms & Causes
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8. Cardiomyopathy: Symptoms & Causes
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9. Page 103 of Healing With CBD
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10. The Endocannabinoid System: Essential and Mysterious
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11. Cannabidiol Primer for Healthcare Professionals
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12. Cannabidiol (CBD)-What We Know and What We Don’t
    https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
13. Acute Administration of Cannabidiol In Vivo Suppresses Ischaemia-Induced Cardiac Arrhythmias and Reduces Infarct Size When Given at Reperfusion
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936031/
14. Atrial Fibrillation: Symptoms & Causes
    https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
15. Atrial Fibrillation (Afib)
    https://my.clevelandclinic.org/health/diseases/16765-atrial-fibrillation-afib
16. A Single Dose of Cannabidiol Reduces Blood Pressure in Healthy Volunteers in a Randomized Crossover Study
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17. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD)
    https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
18. Page 202 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
19. CBD Products Are Everywhere. But Do They Work?
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20. Page 208 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
21. Page 210 of Healing With CBD
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22. Best Way to Take CBD
    https://www.projectcbd.org/guidance/best-way-take-cbd
23. Ibid.
24. Can vaping damage your lungs? What we do (and don’t) know
    https://www.health.harvard.edu/blog/can-vaping-damage-your-lungs-what-we-do-and-dont-know-2019090417734
25. CBD dosing
    https://www.projectcbd.org/guidance/cbd-dosing
26. Ibid.
27. Page 218 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
28. Tetrahydrocannabinol
    https://www.sciencedirect.com/topics/neuroscience/tetrahydrocannabinol
29. Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent
    https://doi.org/10.2174/157488611798280924
30. CBD & THC: Myths and Misconceptions
    https://www.projectcbd.org/guidance/cbd-thc-myths-and-misconceptions
31. WHO Expert Committee on Drug Dependence: Fortieth Report
    https://apps.who.int/iris/bitstream/handle/10665/279948/9789241210225-eng.pdf
32. Page 190-193 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
33. Ibid.
34. A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans
    https://www.frontiersin.org/articles/10.3389/fphar.2018.01365/full
35. Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092763/
36. Cannabidiol Prescription in Clinical Practice: An Audit on the First 400 Patients in New Zealand
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330185/
37. What are the benefits of CBD — and is it safe to use?
    https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
38. CFR – Code of Federal Regulations Title 21
    https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1240
39. Page 243 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
40. Ibid.
41. CBD Oil: An introduction
    https://www.projectcbd.org/wellness/cbd-oil-introduction
42. Ibid.
43. The Cannabis Terpenes
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763918/
44. Flavonoids as antioxidants
    https://pubmed.ncbi.nlm.nih.gov/10924197/
45. Page 92 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
46. Page 260 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
47. Alternative Medicine in Atrial Fibrillation Treatment—Yoga, Acupuncture, Biofeedback and More
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321072/
48. Comparison Between Therapeutic Effects of Acupuncture and Intravenous Injection of Amiodarone in the Treatment of Paroxymal Atrial Fibrillation and Atrial Flutter
    https://pubmed.ncbi.nlm.nih.gov/17370488/
49. Alternative Medicine in Atrial Fibrillation Treatment—Yoga, Acupuncture, Biofeedback and More
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321072/
50. Oral Vitamin C Administration Reduces Early Recurrence Rates After Electrical Cardioversion of Persistent Atrial Fibrillation and Attenuates Associated Inflammation
    https://pubmed.ncbi.nlm.nih.gov/15982504/
51. Alternative Medicine in Atrial Fibrillation Treatment—Yoga, Acupuncture, Biofeedback and More
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321072/
52. Ibid.
53. Omega-3 Fatty Acids for the Prevention of Recurrent Symptomatic Atrial Fibrillation: Results of the FORWARD (Randomized Trial to Assess Efficacy of PUFA for the Maintenance of Sinus Rhythm in Persistent Atrial Fibrillation) Trial
    https://pubmed.ncbi.nlm.nih.gov/23265344/
54. Alternative Medicine in Atrial Fibrillation Treatment—Yoga, Acupuncture, Biofeedback and More
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321072/
55. Ibid.
56. Homeopathy: What You Need To Know
    https://www.nccih.nih.gov/health/homeopathy
57. Ayurveda
    https://www.msdmanuals.com/home/special-subjects/integrative-complementary-and-alternative-medicine/ayurveda
58. CBD & THC: Myths and Misconceptions
    https://www.projectcbd.org/cbd-101/cbd-misconceptions
59. Hemp Production
    https://www.ams.usda.gov/rules-regulations/hemp
60. Hemp Production and the 2018 Farm Bill
    https://www.fda.gov/news-events/congressional-testimony/hemp-production-and-2018-farm-bill-07252019
61. State Medical Cannabis Laws
    https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
62. FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease
    https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare#
63. What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD
    https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
64. Atrial Fibrillation: Symptoms & Causes
    https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
65. Atrial Fibrillation (Afib)
    https://my.clevelandclinic.org/health/diseases/16765-atrial-fibrillation-afib
66. Ibid.
67. Beyond Cardioversion, Ablation and Pharmacotherapies: Risk Factors, Lifestyle Change and Behavioral Counseling Strategies in the Prevention and Treatment of Atrial Fibrillation
    https://pubmed.ncbi.nlm.nih.gov/34023354/
68. Atrial Fibrillation: Symptoms & Causes
    https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
69. Atrial Fibrillation
    https://www.msdmanuals.com/professional/cardiovascular-disorders/arrhythmias-and-conduction-disorders/atrial-fibrillation
70. Atrial Fibrillation: Symptoms & Causes
    https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
71. Ibid.
72. Atrial Fibrillation: Diagnosis & Treatment
    https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/diagnosis-treatment/drc-20350630
73. Ibid.
74. Cardiac Rehab
    https://my.clevelandclinic.org/health/treatments/22069-cardiac-rehab
75. Ibid.

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